Scientific Council Forty-ninth Session SC/49/6 03/12/2012 Lyon, 30 January–1 February 2013 Auditorium DIRECTOR’S RESPONSE TO THE REVIEWS OF THE SECTION OF CANCER INFORMATION (CIN) AND THE SECTION OF ENVIRONMENT AND RADIATION (ENV) 1. The Section of Cancer Information (CIN) and the Section of Environment and Radiation (ENV) were reviewed in January 2012 and the respective Scientific Reports were presented to the 48th session of the Scientific Council (see documents SC/48/WP3 and SC/48/WP4 respectively). The current document provides a summary from the Director of the responses following each of the Reviews. Section of Cancer Information (CIN) 2. The lack of accurate data on cancer burden in many low- and middle-income countries was recognized by the Scientific Council, and the creation of population-based cancer registries producing good quality data in these regions was highlighted as a priority in response to the UN Political Declaration on NCDs (2011). The Council endorsed the establishment of the Global Initiative for Cancer Registry Development in Low and Middle-Income Countries (GICR), alongside the proposed hub structure to provide regional support to the capacity building programme for cancer registries. 3. Since the review the first hub at the Tata Memorial Centre (TMC) in Mumbai, India was formally inaugurated in October 2012, providing support to cancer registries in Southern and South Eastern Asia. A second hub, located in Izmir, Turkey will be established in December 2012 in collaboration with the Turkish Ministry of Health, tasked with assisting cancer registries in Northern Africa and Western Asia. The African Cancer Registry Network (http://afcrn.org) is acting as a consortium to provide hub activities for cancer registries in Sub Saharan Africa. The establishment of a hub for registries in Latin America and the Caribbean is currently under discussion; this hub is expected to become operational in 2013 and the Director has provided funds to prime this development. 4. The Scientific Council was keen to see a global assessment of the status of cancer registration on a country by country basis, considering availability, quality and utilization of data. This appraisal is now underway with one of the first deliverables for each hub being a detailed categorization of registries and their needs within their respective regions. This needs assessment, in conjunction with site visits, will enable identification of appropriate capacity development initiatives. Scientific Council Director’s response to CIN & ENV Reviews SC/49/6 Page 2 5. A GICR Principal Investigators Group has been established, chaired by the CIN Deputy Section Head, to coordinate activities across the different hubs and, inter alia, to prepare the comprehensive management guide suggested by the Scientific Council when sufficient experience has been accumulated. 6. A phased introduction of new hubs with adequate staffing to support this expansion was recommended. The need for the creation of specific hub support posts has been acknowledged by the partners on the GICR Advisory Group, notably UICC who is leading the fund raising component. A comprehensive budget for the GICR has been developed including resources for the hubs and for IARC, with the latter including P3 grade staff appointments to provide hub support. To ensure momentum the Director has made funds available to proceed with the first such P3 scientist appointment. 7. In relation to the Section’s training activities, a programme to “train the trainers” in the operation and use of CanReg5 was initiated in the context of GICR, so staff attached to the hubs can provide local support and answer queries from registries. More generally, training courses in cancer registration and analysis for staff from cancer registries were undertaken during 2012 in Mumbai, India and Cali, Colombia, with further courses planned for 2013 in Thailand, Indonesia, India and North Africa. Finally, a series of six webinars were held on various aspects of CanReg5, from installation to analytical tools. Recordings of these have been made available online for streaming or direct downloading. 8. Following the recommendation to expand and refine the tools for analysis, interpretation and dissemination of the cancer registration data available at the Agency, CIN released updates of the CanReg5 software with a range of improvements and new features (e.g. novel analytical tables). The software has been further translated into Portuguese and translation into Mongolian, Georgian, Turkish, and Arabic has been initiated. 9. Following the withdrawal of European Commission (EC) funds, concerns were expressed by the Scientific Council at the likely future of the European Network of Cancer Registries (ENCR), the Secretariat of which has been hosted at IARC since its inception. During 2012, following a proposal from the EC Directorate General for Health, a new cancer unit within the EC Joint Research Centre (JRC) in Ispra, Italy has been resourced and established and it has been agreed by ENCR that this unit will henceforth maintain the ENCR Secretariat. CIN is working with staff from the JRC to enable a smooth transfer of the Secretariat function. Through a contractual arrangement with the JRC, CIN will remain as the coordinator for data receipt from cancer registries and will maintain responsibility for processing and disseminating these data, their analyses and interpretation. 10. The European Cancer Observatory was launched including estimates for the burden of cancer in Europe in 2012. The Observatory made use of new web technology for the display of summary statistical information and this will be adopted more widely within CIN. 11. The information available in GLOBOCAN was expanded with the inclusion of data on prevalence and disability-adjusted life-years (DALYs). The next release of this resource planned for mid-2013 will also incorporate the suggested indicators of data quality underlying country specific estimates and will make use of new web technology described above. SC/49/6 Page 3 Scientific Council Director’s response to CIN & ENV Reviews 12. Innovative, graphic-based approaches have also been used in the development of a global cancer factsheet1 in collaboration with Cancer Research UK and in the preparation of a 2nd edition of the World Cancer Atlas in collaboration with the American Cancer Society and UICC. 13. The need for additional staff and resources in all the above areas was highlighted by the Council. The Director approved the above-mentioned P3 scientist post focused on hub support and the appointment of a P2 grade IT Development Manager whose main responsibilities will include the planning and coordination of relevant new IT initiatives, such as database improvements and web site maintenance. CIN has three new postdoctoral scientists commencing shortly, one an IARC Fellow and two on extra budgetary funds, resulting from two successful grant applications during 2012 (EU Marie Curie and WCRF). Additional external funds will be needed to enable the planned work on descriptive studies. The need to ensure adequate training opportunities for its staff is being assessed through the annual performance review process. 14. The Council stressed the importance of balancing the Section’s activities in cancer registration with its role in methodological development in descriptive epidemiology, and in leading collaborative methodological networks. Work on a definitive monograph presenting incidence and mortality trends for 27 cancers from 1960–2010 in five continents will be initiated in 2013. This will provide a primary reference source on changing trends in cancer incidence and mortality worldwide. This monograph will be based on data in Cancer Incidence in Five Continents and analyses will include both observed trends and model-based descriptions. An online version with periodical updates will be made available in a dedicated web site providing an important new resource for the global cancer research community. 15. Still in the area of methodological development, the Section will establish early in 2013 an International Descriptive Epidemiology Advisory (IDEA) Group, which will include a panel of external members. The IDEA Group will convene at IARC annually with an initial remit to discuss the planned programme of work of the Section and identify leading experts as potential collaborators in specific areas. Three experts with complementary backgrounds in statistics and/or descriptive epidemiology have been identified as candidates for the IDEA Group. Section of Environment and Radiation (ENV) 16. The Council recommended the development of criteria for prioritizing research topics and that an attempt be made to define the work of the Section on a programmatic basis, in order to seek more flexible and sustainable funding. 17. At the time of the peer-review ENV was a recently-created Section, with relatively new leadership. Since that time, some projects remaining from before this transition period have been completed and current projects now fall into a more focused list of research topics, as follows: a) pesticides; b) occupation; c) diagnostic radiation; d) nuclear accidents; e) electromagnetic fields; f) oesophageal cancer and breast cancer in Africa; and g) causes and survival of childhood leukaemia. The Section also participates in two major IARC initiatives, 1 http://www.iarc.fr/en/media-centre/iarcnews/pdf/Global%20factsheet-2012.pdf Scientific Council Director’s response to CIN & ENV Reviews SC/49/6 Page 4 namely the update of the European Code against Cancer and a revision of the Cancer Epidemiology teaching book. 18. Each of the above research topics is structured such that there is at least one professional level scientist involved, supported by either the Section Head or the Deputy Section Head. 19. Major grant applications have been submitted for non-ionizing radiation and several smaller grants allow programmatic continuation with studies of pesticides and cancer risks. Funding applications are underway for broader support of the activities in Africa. Several complementary activities on childhood leukaemia add to a programmatic basis receiving funding from the European Commission and the German government and pending funding applications to various childhood cancer charities. Radiation projects are funded by the European Commission. 20. The Council recommended that additional resources should be assigned to create a renewable post in occupational epidemiology and an intermediate level post in exposure assessment. In response, extra-budgetary resources were identified for a P2 post in occupational epidemiology for a two-year period and it is planned to seek further funds to continue this post. With respect to exposure assessment, this area is mainly addressed through close collaboration with external institutions, for example, the University of Utrecht, with exchanges of post-doctoral fellows being explored. 21. Strengthening of the IT infrastructure was also suggested to enhance data analysis and security. During the summer of 2012 the computing facilities at IARC have been improved by a complete replacement of the Local Area Network (LAN). The goal was to homogenize and modernize IARC’s LAN infrastructure, increase network security, provide centralized network management and future proof the network for use with new technologies. 22. The Council mentioned the need for mentoring of junior investigators in how to obtain funding. The junior scientists in the Section do take advantage of the generic IARC courses on obtaining funding. In addition, all current junior staff in the Section have been involved in at least one funding application, whilst they are also encouraged to apply for their own funding on a smaller scale, e.g. travel grants, to advance their skills in grant writing.